Activity of roxithromycin against Toxoplasma gondii in murine models

Chang, Huilan; Péchère, Jean-Claude

doi:10.1093/jac/20.suppl_b.69

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…This figure confirms the clinical inefficacy of pentamidine in the prevention of toxoplasmosis, and should be viewed in the context of the rate of onset of cerebral toxoplasmosis in HIVpositive patients, which at present in France is estimated at 15.3% [14]. In contrast, there are extensive data [1][2][3][4][5]13] on the antitoxoplasma activity of roxithromycin, both in vitro and in vivo in animals. These reflect the parasitostatic and sometimes parasiticidal action of the drug on T. gondii.…”

Section: Cerebral Toxoplasmosissupporting

confidence: 53%

“…In a pilot study in 1989 on the prevention of PCP and cerebral toxoplasmosis, we compared roxithromycin with pentamidine aerosols. Roxithromycin, an ether oxime derivative of erythromycin, was chosen on the basis of in vitro and in vivo efficacy in animal studies with Toxoplasma gondii infection [1][2][3][4][5] and of the clinical efficacy against PCP in patients intolerant of trimethoprim/sulphamethoxazole (TMP/SMX) and of pentamidine [6]. The pharmacokinetic properties of roxithromycin, namely high serum cerebral tissue concentrations [7], long half-life [8], and good tolerance [9] also favoured this choice.…”

Section: Introductionmentioning

confidence: 99%

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Prevention ofPneumocystis carinii pneumonia and of cerebral toxoplasmosis by roxithromycin in HIV-infected patients

et al. 1995

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The prevention of cerebral toxoplasmosis and of Pneumocystis carinii pneumonia is an essential objective in the management of patients infected with HIV. Given that roxithromycin is active in vitro against Toxoplasma gondii and that in 1989 Dolermann reported the effective treatment of P. carinii respiratory infections with erythromycin, a randomized pilot study was undertaken in 52 patients infected with HIV. Patients were treated with either: a monthly dose of pentamidine aerosol (300 mg); roxithromycin once a week (300 mg t.i.d.); or a combination of pentamidine aerosol and roxithromycin. Intention to treat analysis was applied to these 52 patients, all of whom received at least one treatment dose. Five out of 18 patients treated with pentamidine aerosol, 1/17 patients treated with pentamidine aerosol + roxithromycin and none of the 17 patients treated with roxithromycin developed cerebral toxoplasmosis (p = 0.038). P. carinii pneumonia was diagnosed in one patient in the pentamidine aerosol-treated group, in one patient treated with roxithromycin and in none of the patients treated with pentamidine aerosol + roxithromycin (non-significant difference). Four cases of Mycobacterium tuberculosis and Mycobacterium avium-intracellulare infection were seen in the pentamidine aerosol-treated group (p = 0.028) and none in the roxithromycin groups. Adverse events leading to the discontinuation of treatment occurred in 5/34 (14.7%) patients treated with roxithromycin. Nausea, abdominal pain and raised transaminases occurred in four patients and a skin allergy in the final patient. Roxithromycin appears to be effective in the prevention of pulmonary pneumocystis infection and of cerebral toxoplasmosis in HIV-infected patients. However, these results require confirmation in a larger study.

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Section: Cerebral Toxoplasmosissupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Prevention ofPneumocystis carinii pneumonia and of cerebral toxoplasmosis by roxithromycin in HIV-infected patients

et al. 1995

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“…1990). Utilizing a mouse model for toxoplasmic encephalitis, Hofflin and Remington (1987b) and Chang and Pechere (1987) found that roxithromycin and interferon act synergistically to delay death against cerebral toxoplasmosis; similarly, azithromycin acts synergistically with interferon against murine cerebral toxoplasmosis (Araujo et al 1988). Pyrimethamine-clindamycin mixtures have been used to treat human cerebral toxoplasmosis in AIDS patients.…”

Section: Treatment Of T Gondii Infectionsmentioning

confidence: 99%

Foodborne Toxoplasmosis

Smith

1991

Journal of Food Safety

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Toxoplasmosis, a disease of mammals and birds, is caused by the obligate intracellular protozoan parasite, Toxoplasma gondii. It is believed that approximately half of the human population of the U.S. is infected and that 500 million of the world population demonstrate a positive serological reaction to the parasite. Only a small percentage of the infected individuals show symptoms: however, in immunocompromised persons, the disease can be quite severe and even fatal. The infectious agent is generally foodborne and is due to the ingestion of raw or undercooked meats derived from infected animals. In this review, several aspects of the T. gondii organism, including its survival, its distribution in the environment and animals, its presence and survival in foods, role of virulence factors, and its transmission to humans, are reviewed. In addition, human toxoplasmosis, its treatment and prevention, and the economic aspects of the disease are discussed.

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Recent developments in the prevention and treatment of congenital toxoplasmosis

Dutton

1989

Int Ophthalmol

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The manifestations of congenital toxoplasmosis vary considerably in degree, characteristics and time of onset. Options for prevention of the disease include the appropriate disposal of cat litter and the avoidance of ingestion of both contaminated food and undercooked meat by pregnant women. Immunisation of the domestic cat population is a consideration for the future. Alternatively, immunisation of sero-negative pregnant women awaits the introduction of an effective and safe reagent. Current treatment modalities are not universally effective and new drugs are the subject of active development and research. Screening of pregnant women or perhaps newborn infants are potential options but the cost effectivity has yet to be established in many countries and the results of treatment during pregnancy and early childhood are encouraging but are as yet unproven. The majority of patients with congenital toxoplasmosis eventually develop toxoplasmic retinochoroiditis. Current treatment options for this condition are outlined. Acquired immune deficiency syndrome (AIDS) may, in some cases, represent a recrudescence of congenital intracerebral infection. Current treatment strategies for this condition are discussed.

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Activity of roxithromycin against Toxoplasma gondii in murine models

Cited by 7 publications

References 10 publications

Prevention ofPneumocystis carinii pneumonia and of cerebral toxoplasmosis by roxithromycin in HIV-infected patients

Prevention ofPneumocystis carinii pneumonia and of cerebral toxoplasmosis by roxithromycin in HIV-infected patients

Foodborne Toxoplasmosis

Recent developments in the prevention and treatment of congenital toxoplasmosis

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